Suicide rates in the United States increased across all racial groups in the United States between 1999 and 2020 but were highest among White people, followed by American Indian and Alaskan Native (AIAN) persons. Firearms and hanging were the top methods used, with a sharp and substantial increase in hangings among women. This finding poses a conundrum for clinicians, as suicide prevention strategies based on means restriction are not effective when the primary means is hanging. The research report is published in Annals of Internal Medicine.  

Researchers from Waseda University, Tokyo, studied data from the Centers for Disease Control and Prevention’s (CDC) WONDER database to assess temporal trends and patterns in method-specific suicide by sex and race in the U.S. from 1999 to 2020. Suicide methods were categorized using International Classification of Diseases, 10^th Edition.

The data showed that suicide rates in the United States increased across all racial groups but were highest among White people, followed by AIAN persons. Firearms were the most common method of suicide among men, but suicide by hanging increased rapidly among both men and women. Among AIAN men, firearms and hanging were the major means of suicide, but among AIAN women, hangings increased almost 200% between 1999 and 2020. Substantial increases in rates of hanging were also seen among White women. 

According to the authors, these findings highlight the need for screening to assess suicide risk and to address underlying mental health issues. It is especially important to consider the role of other drivers of suicide, such as economic and social inequality and racism, such has been experienced by AIAN populations. The authors suggest that a combination of comprehensive and focused community-based suicide prevention strategies that are racially relevant need to be implemented at the community and individual levels. 

IMAGE CREDIT: Karolina Grabowska.

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